How much rates vary
Facilitymedian $112 · 10th to 90th $35 to $741Professionalmedian $35 · 10th to 90th $26 to $417
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.02 | Facility | None | $34.67 | $34.67 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $47.86 | Professional | None | $33.11 | $35.48 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $54.95 | Professional | None | $27.54 | $27.54 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $44.67 Median $70.79 Typical High $151.36 | Facility | None | $44.67 | $70.79 | $151.36 |
BCBS Texas Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $42.66 | Professional | None | $25.70 | $25.70 | $42.66 |
Baylor Scott & White Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $54.95 | Professional | None | $41.69 | $41.69 | $54.95 |
Christus Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Lucent Health Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $416.87 | Professional | None | $275.42 | $416.87 | $416.87 |
Moda Health Setting Facility Modifier None Typical Low $35.48 Median $54.95 Typical High $54.95 | Facility | None | $35.48 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $47.86 | Professional | None | $33.88 | $35.48 | $47.86 |
Providence Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $54.95 | Facility | None | $35.48 | $35.48 | $54.95 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
United Setting Professional Modifier None Typical Low $17.78 Median $27.54 Typical High $38.90 | Professional | None | $17.78 | $27.54 | $38.90 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $17.78 Typical High $19.95 | Professional | 52 · Reduced service | $16.22 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.08 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $6.03 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.55 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.55 | $3.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $16.22 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.08 Typical High $8.71 | Professional | 53 · Discontinued | $6.46 | $7.08 | $8.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.37 Typical High $6.46 | Professional | 55 · Aftercare only | $4.90 | $5.37 | $6.46 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.24 | $3.55 | $4.37 |
Where Texas sits
The same service costs 2.2 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 28th of 51
$35.48
HI $57.54UT $25.70
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.